POSITIVE
mood lift
relaxation
creative, philosophical or deep thinking ... ideas flow well
increased appreciation of music. More aware of, deeper connection to music.
increased awareness of senses. (eating, drinking, smell)
change in experience of muscle fatigue. Pleasant body feel. Increase in body/mind connection.
pain relief (headaches, cramps)
NEUTRAL
general change in consciousness (as with many psychoactives)
increased appetite
slowness (slow driving, talking)
tiredness
blood shot eyes (generally only in inexperienced users)
mouth dryness
interrupts linear memory. Difficulty following a train of thought.
NEGATIVE
nausea
coughing, asthma, upper respiratory problems
difficulty with short term memory
racing heart, agitation, tenseness
headaches
dizziness, confusion
paranoia (generally only in inexperienced users)
possible psychological dependence on cannabis
************************************************************************************************************************************************
A Hashish Overdose
from The Natural Mind
by Andrew Weil
p. 50-51
In 1968, when I was studying marihuana in Boston, I deliberately consumed an overdose (6 grams) of potent hashish in order
to experience this reaction. I took it orally, under observation, and kept notes as long as I was able. The effects of the drug
were felt within forty minutes and were pleasant but strong for about a half-hour. Thereafter, things became quite confusing. I
could not understand what was said to me, felt physically sick, and soon was unfit to do anything but lie in bed and wait for
morning. Auditory hallucinations were prominent, especially threatening voices that rose in volume to a crescendo, the faded
out. For about twelve hours I remained in a stage of consciousness between sleeping and waking, marked by vivid
nightmares. Lucid intervals were rare; for much of the time I did not know where I was, even thinking I was six years old and
sick from measles. By morning, most of the worst symptoms had disappeared, but I had a powerful hangover that left me
prostrate for another twenty-four hours. I would not willingly repeat the experience.
************************************************************************************************************************************************
The Harvard Medical School Mental Health Letter, November 1987
The present generation of young people cannot remember when marijuana was an exotic weed with an aura of mythical power and
mysterious danger. Although still illegal, it has become a commonplace part of the American social scene, used regularly by
millions and occasionally by millions more. A realistic view of this drug is now both more important and easier to achieve.
The use of marijuana reached a high point in the late 1970s and early 1980s, and has been declining ever since. In a 1978 survey,
37 percent of high school seniors said they had smoked marijuana in the last 30 days, and 11 percent said they used it daily. By
1986 the number who said they had smoked it in the last 30 days had fallen to 23 percent - lower than in 1975 - and the proportion
of daily users had dropped steadily to 4 percent. The trend among people aged 18 to 25 is similar. On the other hand, more people
over 25 may be using marijuana occasionally, and young people are still experimenting with it. In 1969, 20 percent of high school
seniors had used marijuana at least once, in 1979, 60 percent had; and in 1985, 54 percent. The attitudes expressed in surveys
show why habitual marijuana use is in decline. In 1978, 65 percent of high school students said they disapproved of it; in 1985, 85
percent disapproved. In 1978, 35 percent said it was very risky, and in 1985, 70 percent said it was.
The main active ingredient of marijuana is delta-9-tetrahydrocannabinol (THC), one of more than 60 related chemicals found in the
resin that covers the flowers and top leaves of the cannabis (hemp) plant. The leaves and flowers can be ground up in drinks or
food, but more often they are dried and smoked in a cigarette or pipe. The pure resin, known as hashish, can also be smoked,
eaten, or drunk. New breeding and cultivation techniques have raised the THC content of marijuana smoked in the United States as
much as ten times over the last 20 years, from an average of 0.4 percent to 4 percent. Some varieties now contain as much as 10
percent.
The effects last two to four hours when marijuana is smoked and five to twelve hours when it is taken by mouth. Although the
intoxication varies with psychological set and social setting, the most common response is a calm, mildly euphoric state in which
time slows and sensitivity to sights, sounds, and touch is enhanced. The smoker may feel exhilaration or hilarity and notice a rapid
flow of ideas with a reduction in short-term memory. Images sometimes appear before closed eyes; visual perception and body
image may undergo subtle changes. It is dangerous to operate complex machinery, including automobiles, under the influence of
marijuana, because it slows reaction time and impairs attention and coordination. This impairment persists for at least several hours
after the feeling of intoxication has passed.
The main physiological effects of cannabis are increased appetite, a faster heartbeat, and slightly bloodshot eyes. Although the
increased heart rate
could be a problem for people with cardiovascular disease, dangerous physical reactions to marijuana are almost unknown. Like
many other drugs, it produces a toxic delirium when taken at very high doses, especially by mouth. The symptoms are confusion,
agitation, disorientation, loss of coordination, and often hallucinations; the delirium ends when the drug passes out of the body. No
human being is known to have died of an overdose. By extrapolation from animal experiments, the ratio of lethal to effective
(intoxicating) dose is estimated to be on the order of thousands to one.
Anxiety Reactions
The most common disturbing reaction to marijuana is acute anxiety, sometimes accompanied by paranoid thoughts. The user
becomes fearful of dying or going insane, and may read hostility or ridicule into the gestures and words of companions. Mounting
anxiety may lead to panic. The most likely victim of this reaction is an inexperienced user inadvertently taking a high dose in an
unpleasant or unfamiliar setting. The best way to handle the anxiety and paranoia is calming support and reassurance. The reaction
is not a psychosis; there are no hallucinations, and reassurance would not be effective without an ability to test the reality of
thoughts and perceptions. Some authorities also refer to a cannabis delusional disorder with feelings of persecution or jealousy.
Whether or not this is distinguishable from the anxiety reaction, the treatment is the same - reassurance and waiting for the drug
effect to fade.
The anxiety reaction or delusional disorder is a milder version of the frightening LSD experience known as a bad trip. A truly
nightmarish experience is rare under the influence of cannabis, because it is less potent than hallucinogenic or psychedelic drugs
and the user is better able to control its effects. Use of LSD and other psychedelic drugs is often followed by flashbacks - the
recurrence of emotions and perceptions originally experienced under the influence of the drug. They usually last only a few
seconds and are not necessarily disturbing, but sometimes they become a persistent problem, which has been labelled
post-hallucinogen perception disorder. Marijuana smoking may precipitate flashbacks in psychedelic drug users; a few reports
suggest that marijuana flashbacks also occur without the previous use of psychedelic drugs.
Some observers, mainly in India and North Africa, have reported a cannabis psychosis caused mainly by long-term heavy use of
the drug. It is described as a prolonged psychotic reaction with symptoms that include delusions, hallucinations, inappropriate
emotions, and disordered thinking. In the descriptions, this psychosis is usually difficult to distinguish from acute schizophrenia,
manic states, panic reactions, and other conditions. The reaction is rarely reported in the United States. Given the many millions of
marijuana smokers in this country, the evidence for it would probably be less equivocal if it occurred with any regularity. Some
people may suffer a psychotic reaction to cannabis because they are vulnerable to psychosis under any stress or after any change in
consciousness or body image. For example, marijuana smoking probably increases the danger of relapse in schizophrenic patients
(although any effect of this kind must be distinguished from a desperate attempt at self-medication because symptoms of
schizophrenia are already returning).
Long-Term Effects
In recent years the psychological and physical effects of long-term use have caused the most concern. Studies are often conflicting
and permit various views of marijuana’s possible harmfulness. This complicates the task of presenting an objective statement about
the issue.
One of the first questions asked about any drug is whether it is addictive or produces dependence. This question is hard to answer
because the terms ‘addiction’ and ‘dependence’ have no agreed-upon definitions. Two recognized signs of addiction are tolerance
and withdrawal symptoms; these are rarely a serious problem for marijuana users. In the early stages, they actually become more
sensitive to the desired effects. After continued heavy use, some tolerance to both physiological and psychological effects
develops, although it seems to vary considerably among individuals. Almost no one reports an urgent need to increase the dose to
recapture the original sensation. What is called behavioral tolerance may be partly a matter of learning to compensate for the effects
of high doses, and may explain why farm workers in some Third World countries are able to do heavy physical labor while
smoking a great deal of marijuana.
A mild withdrawal reaction also occurs in animal experiments and apparently in some human beings who take high doses for a long
time. The symptoms are anxiety, insomnia, tremors, and chills, lasting for a day or two. It is unclear how common this reaction is;
in a Jamaican study, heavy ganja (marijuana) users did not report abstinence symptoms when withdrawn from the drug. In any
case, there is little evidence that the withdrawal reaction ordinarily presents serious problems to marijuana users or causes them to
go on taking the drug.
In a more important sense, dependence means an unhealthy and often unwanted preoccupation with a drug to the exclusion of most
other things. People suffering from drug dependence find that they are constantly thinking about the drug, or intoxicated, or
recovering from its effects. The habit impairs their mental and physical health and hurts their work, family life, and friendships.
They often know that they are using too much and repeatedly make unsuccessful attempts to cut down or stop. These problems
seem to afflict proportionately fewer marijuana smokers than users of alcohol, tobacco, heroin, or cocaine. Even heavy users in
places like Jamaica and Costa Rica do not seem to be dependent in this damaging sense.
Cause or Effect
It is often difficult to distinguish between drug use as a cause of problems and drug use as an effect; this is especially true in the
case of marijuana. Most people who develop a dependency on marijuana would also be likely to develop other dependencies
because of anxiety, depression, or feelings of inadequacy. The original condition is likely to matter more than the attempt to relieve
it by means of the drug. The troubled teenager who smokes cannabis throughout the school day certainly has a problem, and
excessive use of marijuana may be one of its symptoms.
The idea has persisted that in the long run smoking marijuana causes some sort of mental or emotional deterioration. In three major
studies conducted in Jamaica, Costa Rica, and Greece, researchers have compared heavy long-term cannabis users with non-users
and found no evidence of intellectual or neurological damage, no changes in personality, and no loss of the will to work or
participate in society. The Costa Rican study showed no difference between heavy users (seven or more marijuana cigarettes a day)
and lighter users (six or fewer cigarettes a day). Experiments in the United States show no effects of fairly heavy marijuana use on
learning, perception, or motivation over periods as long as a year.
On the other side are clinical reports of a personality change called the amotivational syndrome. Its symptoms are said to be
passivity, aimlessness, apathy, uncommunicativeness, and lack of ambition. Some proposed explanations are hormone changes,
brain damage, sedation, and depression. Since the amotivational syndrome does not seem to occur in Greek or Caribbean farm
laborers, some writers suggest that it affects only skilled and educated people who need to do more complex thinking.
The problem of distinguishing causes from symptoms is particularly acute here. Heavy drug users in our society are often bored,
depressed, and listless, or alienated, cynical, and rebellious. Sometimes the drugs cause these states of mind and sometimes they
result from personality characteristics that lead to drug abuse. Drug abuse can be an excuse for failure or a form of self-medication.
Because of these complications and the absence of confirmation from controlled studies, the existence of an amotivational
syndrome caused by cannabis use has to be regarded as unproven.
Stepping Stone Hypothesis
Much attention has also been devoted to the idea that marijuana smoking leads to the use of opiates and other illicit drugs: the
stepping stone hypothesis. In this country, almost everyone who uses any other illicit drug has smoked marijuana first, just as
almost everyone who smokes marijuana has drunk alcohol first. Anyone who uses any given drug is more likely to be interested in
others, for some of the same reasons. People who use illicit drugs, in particular, are somewhat more likely to find themselves in
company where other illicit drugs are available. None of this proves that using one drug leads to or causes the use of another. Most
marijuana smokers do not use heroin or cocaine, just as most alcohol drinkers do not use marijuana. The metaphor of a stepping
stone suggests that if no one smoked marijuana it would be more difficult for anyone to develop an interest in opiates or cocaine.
There is no convincing evidence for or against this. What is clear is that at many times and places marijuana has been used without
these drugs, or these drugs have been used without marijuana.
It is hard to generalize about abuse or define specific treatments, because the problems associated with marijuana are so vague, and
cause and effect so hard to determine. Marijuana smokers may be using the drug to demonstrate rebelliousness, cope with anxiety,
or medicate themselves for early symptoms of mental illness. People with serious problems who have been smoking marijuana
heavily should be persuaded to stop so that their problems can be more effectively dealt with by psychotherapy or other means.
Health Hazards
Most recent research on the health hazards of marijuana concerns its long-term effects on the body. Studies have examined the
brain, the immune system, the reproductive system, and the lungs. Suggestions of long-term damage come almost exclusively
from animal experiments and other laboratory work. Observations of marijuana users and the Caribbean, Greek, and other studies
reveal little disease or organic pathology associated with the drug.
For example, there are several reports of damaged brain cells and changes in brain-wave readings in monkeys smoking marijuana,
but neurological and neuropsychological tests in Greece, Jamaica, and Costa Rica found no evidence of functional brain damage.
Damage to white blood cells has also been observed in the laboratory, but again, its practical importance is unclear. Whatever
temporary changes marijuana may produce in the immune system, they have not been found to increase the danger of infectious
disease or cancer. If there were significant damage, we might expect to find a higher rate of these diseases among young people
beginning in the 1960s, when marijuana first became popular. There is no evidence of that.
The effects of marijuana on the reproductive system are a more complicated issue. In men, a single dose of THC lowers sperm
count and the level of testosterone and other hormones. Tolerance to this effect apparently develops; in the Costa Rican study,
marijuana smokers and controls had the same testosterone levels. Although the smokers in that study began using marijuana at an
average age of 15, it had not affected their masculine development. There is no evidence that the changes in sperm count and
testosterone produced by marijuana affect sexual performance or fertility.
In animal experiments THC has also been reported to lower levels of female hormones and disturb the menstrual cycle. When
monkeys, rats, and mice are exposed during pregnancy to amounts of THC equivalent to a heavy human smoker’s dose, stillbirths
and decreased birth weight are sometimes reported in their offspring. There are also reports of low birth weight, prematurity, and
even a condition resembling the fetal alcohol syndrome in some children of women who smoke marijuana heavily during
pregnancy. The significance of these reports is unclear because controls are lacking and other circumstances make it hard to
attribute causes. To be safe, pregnant and nursing women should follow the standard conservative recommendation to avoid all
drugs, including cannabis, that are not absolutely necessary.
A well-confirmed danger of long-term heavy marijuana use is its effect on the lungs. Smoking narrows and inflames air passages
and reduces breathing capacity; damage to bronchial cells has been observed in hashish smokers. Possible harmful effects include
bronchitis, emphysema, and lung cancer. Marijuana smoke contains the same carcinogens as tobacco smoke, usually in somewhat
higher concentrations. Marijuana is also inhaled more deeply and held in the lungs longer, which increases the danger. On the other
hand, almost no one smokes 20 marijuana cigarettes a day. Higher THC content in marijuana may reduce the danger of respiratory
damage, because less smoking is required for the desired effect. This is true only as long as no significant tolerance develops, and
as long as users do not try to get a proportionately more intense effect from a stronger form of the drug.
Welcome to Mary Jane's Section.
Erowid.org, one
of the best pot sites i've seen- definitely check it out.
Took most stuff from there. lotz o info...
POSITIVE
mood lift
relaxation
creative, philosophical or deep thinking ... ideas flow well
increased appreciation of music. More aware of, deeper connection to music.
increased awareness of senses. (eating, drinking, smell)
change in experience of muscle fatigue. Pleasant body feel. Increase in body/mind connection.
pain relief (headaches, cramps)
NEUTRAL
general change in consciousness (as with many psychoactives)
increased appetite
slowness (slow driving, talking)
tiredness
blood shot eyes (generally only in inexperienced users)
mouth dryness
interrupts linear memory. Difficulty following a train of thought.
NEGATIVE
nausea
coughing, asthma, upper respiratory problems
difficulty with short term memory
racing heart, agitation, tenseness
headaches
dizziness, confusion
paranoia (generally only in inexperienced users)
possible psychological dependence on cannabis
************************************************************************************************************************************************
A Hashish Overdose
from The Natural Mind
by Andrew Weil
p. 50-51
In 1968, when I was studying marihuana in Boston, I deliberately consumed an overdose (6 grams) of potent hashish in order
to experience this reaction. I took it orally, under observation, and kept notes as long as I was able. The effects of the drug
were felt within forty minutes and were pleasant but strong for about a half-hour. Thereafter, things became quite confusing. I
could not understand what was said to me, felt physically sick, and soon was unfit to do anything but lie in bed and wait for
morning. Auditory hallucinations were prominent, especially threatening voices that rose in volume to a crescendo, the faded
out. For about twelve hours I remained in a stage of consciousness between sleeping and waking, marked by vivid
nightmares. Lucid intervals were rare; for much of the time I did not know where I was, even thinking I was six years old and
sick from measles. By morning, most of the worst symptoms had disappeared, but I had a powerful hangover that left me
prostrate for another twenty-four hours. I would not willingly repeat the experience.
************************************************************************************************************************************************
The Harvard Medical School Mental Health Letter, November 1987
The present generation of young people cannot remember when marijuana was an exotic weed with an aura of mythical power and
mysterious danger. Although still illegal, it has become a commonplace part of the American social scene, used regularly by
millions and occasionally by millions more. A realistic view of this drug is now both more important and easier to achieve.
The use of marijuana reached a high point in the late 1970s and early 1980s, and has been declining ever since. In a 1978 survey,
37 percent of high school seniors said they had smoked marijuana in the last 30 days, and 11 percent said they used it daily. By
1986 the number who said they had smoked it in the last 30 days had fallen to 23 percent - lower than in 1975 - and the proportion
of daily users had dropped steadily to 4 percent. The trend among people aged 18 to 25 is similar. On the other hand, more people
over 25 may be using marijuana occasionally, and young people are still experimenting with it. In 1969, 20 percent of high school
seniors had used marijuana at least once, in 1979, 60 percent had; and in 1985, 54 percent. The attitudes expressed in surveys
show why habitual marijuana use is in decline. In 1978, 65 percent of high school students said they disapproved of it; in 1985, 85
percent disapproved. In 1978, 35 percent said it was very risky, and in 1985, 70 percent said it was.
The main active ingredient of marijuana is delta-9-tetrahydrocannabinol (THC), one of more than 60 related chemicals found in the
resin that covers the flowers and top leaves of the cannabis (hemp) plant. The leaves and flowers can be ground up in drinks or
food, but more often they are dried and smoked in a cigarette or pipe. The pure resin, known as hashish, can also be smoked,
eaten, or drunk. New breeding and cultivation techniques have raised the THC content of marijuana smoked in the United States as
much as ten times over the last 20 years, from an average of 0.4 percent to 4 percent. Some varieties now contain as much as 10
percent.
The effects last two to four hours when marijuana is smoked and five to twelve hours when it is taken by mouth. Although the
intoxication varies with psychological set and social setting, the most common response is a calm, mildly euphoric state in which
time slows and sensitivity to sights, sounds, and touch is enhanced. The smoker may feel exhilaration or hilarity and notice a rapid
flow of ideas with a reduction in short-term memory. Images sometimes appear before closed eyes; visual perception and body
image may undergo subtle changes. It is dangerous to operate complex machinery, including automobiles, under the influence of
marijuana, because it slows reaction time and impairs attention and coordination. This impairment persists for at least several hours
after the feeling of intoxication has passed.
The main physiological effects of cannabis are increased appetite, a faster heartbeat, and slightly bloodshot eyes. Although the
increased heart rate
could be a problem for people with cardiovascular disease, dangerous physical reactions to marijuana are almost unknown. Like
many other drugs, it produces a toxic delirium when taken at very high doses, especially by mouth. The symptoms are confusion,
agitation, disorientation, loss of coordination, and often hallucinations; the delirium ends when the drug passes out of the body. No
human being is known to have died of an overdose. By extrapolation from animal experiments, the ratio of lethal to effective
(intoxicating) dose is estimated to be on the order of thousands to one.
Anxiety Reactions
The most common disturbing reaction to marijuana is acute anxiety, sometimes accompanied by paranoid thoughts. The user
becomes fearful of dying or going insane, and may read hostility or ridicule into the gestures and words of companions. Mounting
anxiety may lead to panic. The most likely victim of this reaction is an inexperienced user inadvertently taking a high dose in an
unpleasant or unfamiliar setting. The best way to handle the anxiety and paranoia is calming support and reassurance. The reaction
is not a psychosis; there are no hallucinations, and reassurance would not be effective without an ability to test the reality of
thoughts and perceptions. Some authorities also refer to a cannabis delusional disorder with feelings of persecution or jealousy.
Whether or not this is distinguishable from the anxiety reaction, the treatment is the same - reassurance and waiting for the drug
effect to fade.
The anxiety reaction or delusional disorder is a milder version of the frightening LSD experience known as a bad trip. A truly
nightmarish experience is rare under the influence of cannabis, because it is less potent than hallucinogenic or psychedelic drugs
and the user is better able to control its effects. Use of LSD and other psychedelic drugs is often followed by flashbacks - the
recurrence of emotions and perceptions originally experienced under the influence of the drug. They usually last only a few
seconds and are not necessarily disturbing, but sometimes they become a persistent problem, which has been labelled
post-hallucinogen perception disorder. Marijuana smoking may precipitate flashbacks in psychedelic drug users; a few reports
suggest that marijuana flashbacks also occur without the previous use of psychedelic drugs.
Some observers, mainly in India and North Africa, have reported a cannabis psychosis caused mainly by long-term heavy use of
the drug. It is described as a prolonged psychotic reaction with symptoms that include delusions, hallucinations, inappropriate
emotions, and disordered thinking. In the descriptions, this psychosis is usually difficult to distinguish from acute schizophrenia,
manic states, panic reactions, and other conditions. The reaction is rarely reported in the United States. Given the many millions of
marijuana smokers in this country, the evidence for it would probably be less equivocal if it occurred with any regularity. Some
people may suffer a psychotic reaction to cannabis because they are vulnerable to psychosis under any stress or after any change in
consciousness or body image. For example, marijuana smoking probably increases the danger of relapse in schizophrenic patients
(although any effect of this kind must be distinguished from a desperate attempt at self-medication because symptoms of
schizophrenia are already returning).
Long-Term Effects
In recent years the psychological and physical effects of long-term use have caused the most concern. Studies are often conflicting
and permit various views of marijuana’s possible harmfulness. This complicates the task of presenting an objective statement about
the issue.
One of the first questions asked about any drug is whether it is addictive or produces dependence. This question is hard to answer
because the terms ‘addiction’ and ‘dependence’ have no agreed-upon definitions. Two recognized signs of addiction are tolerance
and withdrawal symptoms; these are rarely a serious problem for marijuana users. In the early stages, they actually become more
sensitive to the desired effects. After continued heavy use, some tolerance to both physiological and psychological effects
develops, although it seems to vary considerably among individuals. Almost no one reports an urgent need to increase the dose to
recapture the original sensation. What is called behavioral tolerance may be partly a matter of learning to compensate for the effects
of high doses, and may explain why farm workers in some Third World countries are able to do heavy physical labor while
smoking a great deal of marijuana.
A mild withdrawal reaction also occurs in animal experiments and apparently in some human beings who take high doses for a long
time. The symptoms are anxiety, insomnia, tremors, and chills, lasting for a day or two. It is unclear how common this reaction is;
in a Jamaican study, heavy ganja (marijuana) users did not report abstinence symptoms when withdrawn from the drug. In any
case, there is little evidence that the withdrawal reaction ordinarily presents serious problems to marijuana users or causes them to
go on taking the drug.
In a more important sense, dependence means an unhealthy and often unwanted preoccupation with a drug to the exclusion of most
other things. People suffering from drug dependence find that they are constantly thinking about the drug, or intoxicated, or
recovering from its effects. The habit impairs their mental and physical health and hurts their work, family life, and friendships.
They often know that they are using too much and repeatedly make unsuccessful attempts to cut down or stop. These problems
seem to afflict proportionately fewer marijuana smokers than users of alcohol, tobacco, heroin, or cocaine. Even heavy users in
places like Jamaica and Costa Rica do not seem to be dependent in this damaging sense.
Cause or Effect
It is often difficult to distinguish between drug use as a cause of problems and drug use as an effect; this is especially true in the
case of marijuana. Most people who develop a dependency on marijuana would also be likely to develop other dependencies
because of anxiety, depression, or feelings of inadequacy. The original condition is likely to matter more than the attempt to relieve
it by means of the drug. The troubled teenager who smokes cannabis throughout the school day certainly has a problem, and
excessive use of marijuana may be one of its symptoms.
The idea has persisted that in the long run smoking marijuana causes some sort of mental or emotional deterioration. In three major
studies conducted in Jamaica, Costa Rica, and Greece, researchers have compared heavy long-term cannabis users with non-users
and found no evidence of intellectual or neurological damage, no changes in personality, and no loss of the will to work or
participate in society. The Costa Rican study showed no difference between heavy users (seven or more marijuana cigarettes a day)
and lighter users (six or fewer cigarettes a day). Experiments in the United States show no effects of fairly heavy marijuana use on
learning, perception, or motivation over periods as long as a year.
On the other side are clinical reports of a personality change called the amotivational syndrome. Its symptoms are said to be
passivity, aimlessness, apathy, uncommunicativeness, and lack of ambition. Some proposed explanations are hormone changes,
brain damage, sedation, and depression. Since the amotivational syndrome does not seem to occur in Greek or Caribbean farm
laborers, some writers suggest that it affects only skilled and educated people who need to do more complex thinking.
The problem of distinguishing causes from symptoms is particularly acute here. Heavy drug users in our society are often bored,
depressed, and listless, or alienated, cynical, and rebellious. Sometimes the drugs cause these states of mind and sometimes they
result from personality characteristics that lead to drug abuse. Drug abuse can be an excuse for failure or a form of self-medication.
Because of these complications and the absence of confirmation from controlled studies, the existence of an amotivational
syndrome caused by cannabis use has to be regarded as unproven.
Stepping Stone Hypothesis
Much attention has also been devoted to the idea that marijuana smoking leads to the use of opiates and other illicit drugs: the
stepping stone hypothesis. In this country, almost everyone who uses any other illicit drug has smoked marijuana first, just as
almost everyone who smokes marijuana has drunk alcohol first. Anyone who uses any given drug is more likely to be interested in
others, for some of the same reasons. People who use illicit drugs, in particular, are somewhat more likely to find themselves in
company where other illicit drugs are available. None of this proves that using one drug leads to or causes the use of another. Most
marijuana smokers do not use heroin or cocaine, just as most alcohol drinkers do not use marijuana. The metaphor of a stepping
stone suggests that if no one smoked marijuana it would be more difficult for anyone to develop an interest in opiates or cocaine.
There is no convincing evidence for or against this. What is clear is that at many times and places marijuana has been used without
these drugs, or these drugs have been used without marijuana.
It is hard to generalize about abuse or define specific treatments, because the problems associated with marijuana are so vague, and
cause and effect so hard to determine. Marijuana smokers may be using the drug to demonstrate rebelliousness, cope with anxiety,
or medicate themselves for early symptoms of mental illness. People with serious problems who have been smoking marijuana
heavily should be persuaded to stop so that their problems can be more effectively dealt with by psychotherapy or other means.
Health Hazards
Most recent research on the health hazards of marijuana concerns its long-term effects on the body. Studies have examined the
brain, the immune system, the reproductive system, and the lungs. Suggestions of long-term damage come almost exclusively
from animal experiments and other laboratory work. Observations of marijuana users and the Caribbean, Greek, and other studies
reveal little disease or organic pathology associated with the drug.
For example, there are several reports of damaged brain cells and changes in brain-wave readings in monkeys smoking marijuana,
but neurological and neuropsychological tests in Greece, Jamaica, and Costa Rica found no evidence of functional brain damage.
Damage to white blood cells has also been observed in the laboratory, but again, its practical importance is unclear. Whatever
temporary changes marijuana may produce in the immune system, they have not been found to increase the danger of infectious
disease or cancer. If there were significant damage, we might expect to find a higher rate of these diseases among young people
beginning in the 1960s, when marijuana first became popular. There is no evidence of that.
The effects of marijuana on the reproductive system are a more complicated issue. In men, a single dose of THC lowers sperm
count and the level of testosterone and other hormones. Tolerance to this effect apparently develops; in the Costa Rican study,
marijuana smokers and controls had the same testosterone levels. Although the smokers in that study began using marijuana at an
average age of 15, it had not affected their masculine development. There is no evidence that the changes in sperm count and
testosterone produced by marijuana affect sexual performance or fertility.
In animal experiments THC has also been reported to lower levels of female hormones and disturb the menstrual cycle. When
monkeys, rats, and mice are exposed during pregnancy to amounts of THC equivalent to a heavy human smoker’s dose, stillbirths
and decreased birth weight are sometimes reported in their offspring. There are also reports of low birth weight, prematurity, and
even a condition resembling the fetal alcohol syndrome in some children of women who smoke marijuana heavily during
pregnancy. The significance of these reports is unclear because controls are lacking and other circumstances make it hard to
attribute causes. To be safe, pregnant and nursing women should follow the standard conservative recommendation to avoid all
drugs, including cannabis, that are not absolutely necessary.
A well-confirmed danger of long-term heavy marijuana use is its effect on the lungs. Smoking narrows and inflames air passages
and reduces breathing capacity; damage to bronchial cells has been observed in hashish smokers. Possible harmful effects include
bronchitis, emphysema, and lung cancer. Marijuana smoke contains the same carcinogens as tobacco smoke, usually in somewhat
higher concentrations. Marijuana is also inhaled more deeply and held in the lungs longer, which increases the danger. On the other
hand, almost no one smokes 20 marijuana cigarettes a day. Higher THC content in marijuana may reduce the danger of respiratory
damage, because less smoking is required for the desired effect. This is true only as long as no significant tolerance develops, and
as long as users do not try to get a proportionately more intense effect from a stronger form of the drug.